Nasal bleeding

All dead at day 15, with death preceded by nasal bleeding and listless swimming... 

Pain and sneezing, nasal bleeding Systemic toxicity if sufficient toxin is ingested or inhaled characterized by weakness, dizziness, loss of coordination, low blood pressure, rapid heartbeat, and low body temperature death can occur in minutes to days... 

Animal studies also indicate that the respiratory system is a major target of toxicity following inhalation exposure to chlorine dioxide. Dalhamn (1957) reported the results of several inhalation studies in laboratory animals. In one study, a single 2-hour inhalation exposure of four rats to a chlorine dioxide concentration of 260 ppm (728 mg/m ) resulted in pulmonary edema and nasal bleeding. Respiratory distress was reported in three other rats subjected to 3 weekly 3-minute exposures to decreasing concentrations of airborne chlorine dioxide from 3,400 to 800 ppm (from 9,520 to 2,240 mg/m ) bronchopneumonia was observed in two of these rats. In a third rat study, repeated exposure to approximately 10 ppm (28 mg/m ) of chlorine dioxide (4 hours/day for 9 days in a 13-day period) resulted in rhinonhea, altered respiration, and respiratory infection. No indications of adverse effects were seen in rats exposed to approximately 0.1 ppm (0.28 mg/m ) of chlorine dioxide 5 hours /day for 10 weeks. 

A 69-year-old man with idiopathic nasal bleeding underwent contrast-enhanced CT examination of the head with an intravenous non-ionic low-osmolar contrast medium (96). Convulsions and tremor developed 1 hour after the examination and lasted for 50 minutes. 

Rat Mouse 6CHXI-24 000 ppm 13 weeks Nasal bleeding and abdominal distension Increased liver and kidney weights No mortalities... 

Corrosive— inhalation, skin, eye. Poisoning may affect teeth kidneys. Acute exposure choking, coughing, chills, chest pain, pulmonary inflammation, edema. Chronic exposure nasal bleeding, dryness, fluorosis, joint stiffness, general weakness among several other effects. 

The most common adverse effects of intranasal steroids are local irritation (e.g., a burning or stinging sensation) and nasal bleeding. Proper use has not been associated with mucosal atrophy. Long-term use has rarely been associated with nasal septal perforation. Nasal septal perforation may be the result of trauma from the spray velocity combined with vasoconstrictor activity of the steroid. Patients should be instructed to direct the spray away from the nasal septum, and physicians should periodically examine the septum for mucosal erosions, which may precede nasal septal perforation (54). 

Is the patient taking antihistamines and/or intranasal steroids Is the patient experiencing adverse effects (e.g., sedation from antihistamines or nasal itching, burning, or bleeding from intranasal corticosteroids) ... 

Primary therapy is based on disease severity and type of hemorrhage.7 Most patients with mild to moderate disease and a minor bleeding episode can be treated with l-desamino-8-D-arginine vasopressin [desmopressin acetate (DDAVP)], a synthetic analog of the antidiuretic hormone vasopressin. DDAVP causes release of von Willebrand factor (vWF) and factor VIII from endogenous storage sites. This formulation increases plasma factor VIII levels by three- to fivefold within 30 minutes. The recommended dose is 0.3 mcg/kg intravenously (in 50 mL normal saline infused over 15 to 30 minutes) or subcutaneously or 300 meg intranasally via concentrated nasal spray every 12 hours. Peak effect with intranasal administration occurs 60 to 90 minutes after administration, which is somewhat later than with intravenous administration. Desmopressin infusion may be administered daily for up to 2 to 3 days. Tachyphylaxis, an attenuated response with repeated administration, may occur after several doses.8... 

Under normal conditions of exposure borates are primarily irritants of the skin and respiratory system. Workers exposed to anhydrous sodium tetraborate complained of nasal irritation, nose bleeds, cough, shortness of breath, and dermatitis. Exposure levels were not measured, but total dust levels were described as high enough to obscure visibility in production areas. In another study of borax workers, symptoms of acute respiratory irritation including dryness of the mouth, nose, or throat, cough, nosebleeds, and shortness of breath were related to exposures of 4mg/m or more. ... 

Administered to mice, 49,000 ppm for 51 minutes resulted in narcosis, muscular hypotonia, disappearance of corneal reflexes, then coma followed by death. The LC50 was estimated to be 21,000 ppm in rats exposed for 3 hours. Repeated exposure of rats to concentrations ranging from 100 to 5000 ppm for 12 weeks caused a dose-related increase in irritation of the mucous membranes. At the 5000 ppm level there was marked edema or opacity of the cornea, salivation, and discharge or bleeding in the nasal mucosa. 

Phenylephrine, Nasal (Neo-Synephrine Nasal) (OTC) [Vasopressor/Decongestant] Uses Can be used prior to nasal intubation and NG tube insCTtion to reduce bleeding Action a-Adren gic agonist Dose Adults Feds. 1—2 sprays/nostril q4h (usual 0.25%).Caution [C, +/—] HTN, acute pancreatitis, H, coronary Dz, NAG, h5 pCTth5Toidism Contra Bradycardia, arrhythmias Disp Nasal soln (0.125-0.25%) SE Arrh5rthmias, HTN, nasal irritation, dryness, sneezing, HA Interactions May -1- effects OF nitrates EMS Ocular instillation may dilate pupil... 

Oxytocin may be given by intravenous infusion (e.g., labor induction), intramuscular injection (e.g., control of postpartum bleeding), or as a nasal spray (e.g., to promote milk ejection). 

Cocaine differs from the other local anesthetics with respect to its cardiovascular effects. Cocaine s blockade of norepinephrine reuptake results in vasoconstriction and hypertension, as well as cardiac arrhythmias. The vasoconstriction produced by cocaine can lead to local ischemia and, in chronic abusers who use the nasal route, ulceration of the mucous membrane and damage to the nasal septum have been reported. The vasoconstrictor properties of cocaine can be used clinically to decrease bleeding from mucosal damage or surgical trauma in the nasopharyneal region. 

Vasopressin and desmopressin are treatments of choice for pituitary diabetes insipidus. The dosage of desmopressin is 10-40 meg (0.1-0.4 mL) in two to three divided doses as a nasal spray or, as an oral tablet, 0.1-0.2 mg two to three times daily. The dosage by injection is 1-4 meg (0.25-1 mL) every 12-24 hours as needed for polyuria, polydipsia, or hypernatremia. Bedtime desmopressin therapy, by intranasal or oral administration, ameliorates nocturnal enuresis by decreasing nocturnal urine production. Vasopressin infusion is effective in some cases of esophageal variceal bleeding and colonic diverticular bleeding. 

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